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sushantpatel_doc
Coronectomy / Intentional Partial OdontectomySpecific
Warnings:
Antibiotics (pre- & post-op). These are recommended to
lower the chance of infection either in the socket or the
tooth pulp. These will be given at the clinicians’ discretion.
Primary Closure. The retained roots are covered over by
the gum to facilitate healing of the pulp, socket and to
lessen the chance of operation site infection.
Root Canal Treatment of retained roots is not necessary.
Osteo-cementum Growth.
The root margins are trimmed
several millimetres below the crest of the socket to
encourage bone & osteo-cementum formation over the
retained roots, sealing off the roots from the mouth.
Roots inadvertently removed at the time of attempted
coronectomy.
When it came to removing the crown, it was
found that the roots as well were mobile. This ranges from
3 – 9%. If the roots are mobile, we are obliged to remove
them and there is obviously the risk to the IAN (which this
procedure was trying to avoid).
Numbness of Chin, Lip ± Tongue.
The Inferior Alveolar &
Lingual Nerves may still be damaged during the procedure
resulting in numbness affecting the tongue +/- the chin and
lower lip. The numbness of the tongue seems to be quite
short-lived and has a low incidence. The numbness of the
chin ± lip tended to occur when on attempting the
coronectomy, the roots were found to be mobile and had
to be removed.
Root Migration.
Subsequent migration of the roots away
from the IAN occurred in 14 – 81% of cases.
Later Removal of Roots.
This can happen in up to a 2 –
6% of cases. If the roots irritate overlying tissues or the
adjacent tooth or otherwise become symptomatic, they
may need to be removed. Even though a 2nd surgery
would be needed, the possibility of nerve damage should
be negligible since the roots would have migrated away
from its original resting place next to the IAN. Since the
purpose of the coronectomy is to avoid this damage, this
goal would have been accomplished even though a 2nd
surgical procedure was necessary to remove the remaining
root.